The Mölnlycke Health Care blog
The colour coding concept – a lean logistics solution
Arno van der Linden works in CSA Facilities Management, Erasmus Medical Centre in the Netherlands
To achieve maximum efficiency within a hospital, every step and every process is considered as fair game for improvement. The Erasmus Medical Centre (MC) in Rotterdam in The Netherlands took this to heart. Keeping all operations running smoothly requires evaluating and adopting new concepts that can contribute improvements on both large and small scales.
Material flow management is one clear area in which small changes make tangible and visible improvements. Within the CSA Facilities Department of Erasmus Medical Centre, we looked at logistics solutions as a way to introduce lean management principles to our material flow. One visible implementation has been a colour-coding solution that has boosted efficiency and stock management.
We adapted our storage facility for disposable items to keep them in a different location. We place an order once a week to ensure that we are able to carry out the logistical preparations for all operations and interventions at the outpatient clinic.
The outpatient clinic in turn sends us an order each day that we deliver the following day at 2pm. This is how we ensure that everything is arranged for the operations and procedures scheduled to take place a day after that. In practice, this means that an order received from the outpatient clinic on Monday is for operations due to be carried out on Wednesday.
A focus on future organization
We are responsible in our department for the logistical preparation of 15 different surgical trays, subdivided into eight specialist disciplines. These trays are prepared together with the reusable instrument trays. All trays are placed on carts to be sent to the outpatient clinic. This is how things will continue for the time being.
However, a major change is planned for 2017: all logistical preparations will be carried out from within the CSA, which incidentally has the largest operating theatre at the Erasmus MC. The change also applies to the Cancer Institute and the Thorax Centre. With this coming change, the CSA started early in looking for solutions to enable organizational procedures that can carry us through future development.
While many lean principles are applicable, the colour coding concept is one such solution that made sense for us.
While errors are by no means common in our department, and are generally made in the operating theatre – staff may accidentally open the wrong package due to the high time pressure involved with the work of the O.R. – we always seek efficiency improvements and proactively look for ways to avoid errors at any level. With the ongoing evolution of our department firmly in mind, the visual, easy-to-understand and use aspect of colour coding was attractive. It was immediately clear – visually and aesthetically – that we could streamline our approach to work and work processes. The different colours applied to the trays themselves and corresponding colours sheets to each storage rack encouraged compliance and organization while making the structure of the stock immediately clear.
Seamless coordination in the operating theatre
Coloured coding and coloured adhesive strips attached to the racks saves us time. That was the immediate effect. But that was only the first step. This concept led us to think about subdividing the stocks according to discipline and coordinating this with operating theatre procedures. As such, we classified the relevant trays for each discipline. Before, we had assumed that a hand tray located under a foot tray marked "orthopaedics/trauma" would be for the same discipline. Instead, it was actually intended for plastic surgery. When receiving an order, it is highly beneficial that we are able to immediately refer to the correct speciality. Furthermore, the tray itself is easy to find.
The solution will prove its worth once all logistical operations for the other locations are carried out from here – it is seamlessly coordinated with procedures in the operating theatre. The introduction of the concept is an excellent way of preparing for this major change.
Classification and coordination
A classification system was created and colours were defined, which was then coordinated with the operating theatre and with our department.
We evaluated our racks based on the number of different trays being used. Although the concept did not immediately result in saving space, we did ensure that our racks are laid out logically.
Ongoing process improvements
We experienced no disadvantages at all – only benefits. More importantly, the colour-coding process has been a springboard for ongoing process improvements along lean management lines. After our initial implementation of colour coding, we also applied it to the transportation boxes, which takes our efficient operational processes a step further.
We are, from top to bottom, committed to the philosophies of lean management and efficient supply chain and material flow. Launching colour coding has been one real-world embodiment of our philosophy.